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+--- Thread: Hi, I'm new and two weeks into therapy (/Thread-Hi-I-m-new-and-two-weeks-into-therapy)
Hi, I'm new and two weeks into therapy - Huesito - 12-28-2015
Hi everybody.
I've been mostly reading up while getting setup, and I thought it was time to register and thank everyone for the great amount of information and to share my experience so far.
A bit of background: I'm in my early 40's, 6 feet tall, never had any notable health issues until about two months ago. I smoke since I was 19, and switched to ecigs about 4 years ago. About a year ago I started to snore heavily, also coupled with weight gain (I was already fat at 220lbs, went up to 235).
A couple months ago I had an episode of Hypoglycemia, coupled with severe fatigue. I'm self employed, have no insurance, but worked on medical systems for years so after a brief stop at the hospital, I checked with a doc friend of mine. Blood test showed pre-diabetic state, but doc said we caught it on time (plus I have no family history of beetus, which was a plus), put me on a diet and some meds (lost 20lbs in the last 2 months), and with my sugar back on track, the other remaining issue was the severe fatigue...
So we did a home sleep study, and it came back with severe sleep apnea.
Total recording time: 355 mins
Total Hyponeas: 75
Total Apneas: 210
Average Apnea secs: 33
RDI(AHI) 4%: 48%
RDI(AHI): 52.0
Study recommends CPAP therapy with a starting pressure of 8cm H2O
After much reading here and having to pay for everything out of pocket, i visited a local CPAP shop here with prescription in hand from my doc. I bought a DeVilbiss IntelliPAP auto, with the detachable humidifier. Doc said to start at 4-8 and go from there. I tried a few masks (I do breathe from my mouth sometimes, so I went for full face) and the Resmed Quattro Air was very comfortable.
I bought the IntelliPAP because it was priced right for my budget, it's small and the smart codes can get me data I can track daily. And if eventually I want to get niftier with it, I can optionally get a data module to hook into sleepyhead.
First week went great. AHI was 5 or less for all days except one (7.5). I generally felt less fatigued and more in focus. Last week I traveled down south to Texas for the holidays and since I've been here, I noticed that both 90th and 95th percentile were at the max (8) and the pressure plateau crept up to 12%-15%. So two nights ago I moved the pressure range to 4-10. Last night my AHI was 5, the 90/95 percentile were 9.0 and 9.5 respectively and the plateau just 4%.
I was tired very fatigued the last couple of days though, which coincided with a severe change in temperatures too (not sure if it's related).
That said, I'm sticking with it. The machine reports no leaks and I have zero problems sleeping with the mask. I'm putting 7-8 hours of sleep and I'm hoping to start seeing better results in a few weeks.
Thanks again for all the info here, for peeps on a budget like me it's invaluable. I'll be happy to donate when I get back home and I'll post updates in this thread.
RE: Hi, I'm new and two weeks into therapy - OpalRose - 12-28-2015
Welcome to Apnea Board Huesito,
Your start pressure of 4 is too low, especially if you were titrated at 8.
Your start pressure should be slightly under your 90% pressure.
Based on your numbers above, you probably would do better with a pressure range of around 8-12.
If you make changes, try to stick with it for a couple weeks to see how you do.
Would like to see your AHI <5, but most important is how you feel.
RE: Hi, I'm new and two weeks into therapy - Huesito - 12-28-2015
Thank you very much for the suggestion. I will give it a shot and keep with it for two weeks at that setting to see how it goes. I'll keep the ramp up pressure at 4 in case I need it to fall asleep.
RE: Hi, I'm new and two weeks into therapy - trish6hundred - 12-28-2015
Hi Huesito,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and hang in there for more responses to your post.
RE: Hi, I'm new and two weeks into therapy - Huesito - 12-28-2015
Thank you trish, this is all new to me and once again the information here has been great!
RE: Hi, I'm new and two weeks into therapy - vsheline - 12-29-2015
(12-28-2015, 08:50 PM)Huesito Wrote: Thank you very much for the suggestion. I will give it a shot and keep with it for two weeks at that setting to see how it goes. I'll keep the ramp up pressure at 4 in case I need it to fall asleep.
Hi Huesito, welcome to Apnea Board.
Many patients don't like 4 as their start pressure for longer than perhaps the first night. The Start Pressure can/should be adjusted by the user to whatever is most comfortable.
Take care,
--- Vaughn
RE: Hi, I'm new and two weeks into therapy - cate1898 - 12-29-2015
Welcome Huesito to the forum! Glad to see you are getting some helpful tips to improve your CPAP therapy!
RE: Hi, I'm new and two weeks into therapy - Sleeprider - 12-29-2015
Huesito, you've done well to investigate and take care of your medical issues in the absence of insurance coverage. Congrats on your persistence, and the support you received from your doctor. You should retain copies of your prescription and sleep study to increase your options. Be sure to shop your supplies like mask, headgear etc. Online suppliers are generally less expensive than DMEs that may include the services of a respiratory therapist, which you may or may not need. Most online suppliers will retain your prescription and you can make unlimited purchases without renewing the prescription. Call for the best prices, because posted prices online must comply with minimum advertised price (MAP) limitations stipulated by manufacturers. You may be quoted lower prices by phone.
I strongly agree with the previous comments that a pressure range of 4-8 is probably too low. I would set the minimum pressure for comfort so you don't feel air-starved, and let the machine automatically adjust pressure upwards as needed. There is no need to limit the upper pressure range at this time. After several weeks, I would set the minimum pressure at your average pressure, or at your 90% pressure minus 3 cmH2O. This usually results in the most responsive and comfortable treatment. Maximum pressure limits are generally not needed unless you have problems with comfort, air ingestion, central apnea or other issues. The machine only increases pressure to what is needed to eliminate flow limitations, snoring and other indicators of airway collapse. Good luck with your therapy, and well done so far.
RE: Hi, I'm new and two weeks into therapy - Huesito - 12-29-2015
First night on 8-12
AHI: 3.0
95th: 9.0
90th: 9.0
Plateau: 0%
High Leak Flow: 0%
NRI: 1.75
EPI: 3
While Breathing Hours: 8.1
Looking good. We'll see how I feel during the day. Thanks again for the suggestions and will keep on posting.
RE: Hi, I'm new and two weeks into therapy - Huesito - 12-29-2015
(12-29-2015, 09:14 AM)Sleeprider Wrote: Huesito, you've done well to investigate and take care of your medical issues in the absence of insurance coverage. Congrats on your persistence, and the support you received from your doctor. You should retain copies of your prescription and sleep study to increase your options. Be sure to shop your supplies like mask, headgear etc. Online suppliers are generally less expensive than DMEs that may include the services of a respiratory therapist, which you may or may not need. Most online suppliers will retain your prescription and you can make unlimited purchases without renewing the prescription. Call for the best prices, because posted prices online must comply with minimum advertised price (MAP) limitations stipulated by manufacturers. You may be quoted lower prices by phone.
I strongly agree with the previous comments that a pressure range of 4-8 is probably too low. I would set the minimum pressure for comfort so you don't feel air-starved, and let the machine automatically adjust pressure upwards as needed. There is no need to limit the upper pressure range at this time. After several weeks, I would set the minimum pressure at your average pressure, or at your 90% pressure minus 3 cmH2O. This usually results in the most responsive and comfortable treatment. Maximum pressure limits are generally not needed unless you have problems with comfort, air ingestion, central apnea or other issues. The machine only increases pressure to what is needed to eliminate flow limitations, snoring and other indicators of airway collapse. Good luck with your therapy, and well done so far.
Thanks! I'm gonna stick with 8-12 for a couple of weeks and see how it works out.
Basically the hospital bills set me back a bunch even though I was there less than 8 hours. I got a discount with the sleep study but I just didn't follow through with the DME or other docs, due to $$$ but also because I was going to go on this trip and was adamant to have a machine with me and the DME took forever to contact me.
I carry a copy of my sleep study and prescription with me on my cell. Apparently, at least the snoring, is all palate related.
I had zero problem sleeping with 8-12 last night. Just a couple of times I woke up with rainout (I'm still trying to get the hang of the humidifier settings) and also a very tiny leak near my nose when sleeping on the side which I quickly corrected readjusting the mask. The rest was smooth sailing.
We'll see how's the fatigue during the day.